NPI: 1760737647 · ARLINGTON, MN 55307 · Dentist · NPI assigned 07/17/2012
| Authorized Official | GUSTAFSON, JOHN (OWNER) |
| NPI Enumeration Date | 07/17/2012 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $415.16 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $415.16 |